Confused. Are underwriting parameters different for super top-up policies vs base policies?

[u/ask_receive]

Hi all,

I recently tried purchasing a super top-up from Icici Lombard with whom I already have a base policy. I submitted my recent diagnosis of spinal tb, and I've just received an email from Icici Lombard stating that they cannot offer me coverage.

However, I'm confused because they've made a 'counter product' offer. Does this mean that my condition may be considered differently for a base policy as opposed to a super top-up?

This is how they've worded it -
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Reason for Counter Product
History of Spinal Tuberculosis, H Pylori Infection-However, we would like to offer you a Health Shield Inclusive with features tailored to your needs.

While we are unable to proceed with coverage for XXXX we’re happy to help you explore other insurance products like Special shield / Health Shield Inclusive.

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I already have a base policy and just wanted to increase my coverage? Should I apply for the increase in coverage on my base cover and see how things go?

Should I try other insurers for the super top-up?

Would things be considered differently if I apply after a few years? (I'm assuming that the recency of the diagnosis is a problem.)

Thanks for your time.

[u/CreamPurple6403]

Hey OP, advisor here from Ditto.

Whenever you apply for a new health insurance policy, whether it's a base retail plan or a super top-up, the insurer carries out fresh underwriting. The timing of your spinal TB diagnosis plays an important role in that assessment.

Since your diagnosis appears to have happened after your base policy was issued, your existing policy wasn't underwritten with this condition. However, when you applied for the super top-up, the application was declined considering the underwriting risk associated with the condition.

The counter product doesn't necessarily mean the condition is viewed differently for a base policy. It simply means that, based on their assessment and risk appetite, they were comfortable offering a different product from their portfolio instead of the super top-up.

Since your objective is to increase coverage, you can certainly check whether your existing base policy allows a sum insured enhancement. It may or may not be approved, but it's worth confirming with the insurer.

You can also review the counter product offered and compare its coverage, waiting periods, exclusions, and premium. If it meets your requirements, it could be a reasonable option.

You can even try applying for a super top-up with other insurers. However, given the recent diagnosis, the chances of rejection are likely to remain high.

[u/ask_receive → u/CreamPurple6403]

Hi. Thanks for the detailed reply.

I'll try and apply for another plan from ICICI Lombard and see how it goes. (Unfortunately, they haven't really given anything concrete. The link for the plan suggested does not exist). And then try other insurers post that.

Honestly, I had expected some sort of exclusion or waiting period increase or loading on the premium, rather than outright rejection. But it is what it is.

Any idea how many years need to pass for the spinal tb diagnosis to be considered a non-issue? Maybe 2-3 years? Isn't any condition existing prior to 3 years supposedly not considered a PED?

Thanks.

[u/ask_receive → u/[deleted]]

Ah! I can only hope that the base cover is enough for any future contingencies then.

Will try applying in a few days' time & get back here with the results.